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WO2017165623A1 - Calculateur de puissance pour un appareil ophtalmique avec méridiens correctifs ayant une tolérance ou bande opérationnelle étendue - Google Patents

Calculateur de puissance pour un appareil ophtalmique avec méridiens correctifs ayant une tolérance ou bande opérationnelle étendue Download PDF

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Publication number
WO2017165623A1
WO2017165623A1 PCT/US2017/023772 US2017023772W WO2017165623A1 WO 2017165623 A1 WO2017165623 A1 WO 2017165623A1 US 2017023772 W US2017023772 W US 2017023772W WO 2017165623 A1 WO2017165623 A1 WO 2017165623A1
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WO
WIPO (PCT)
Prior art keywords
ophthalmic apparatus
power
implantable
meridian
cylinder
Prior art date
Application number
PCT/US2017/023772
Other languages
English (en)
Inventor
Huawei Zhao
Original Assignee
Abbott Medical Optics Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Abbott Medical Optics Inc. filed Critical Abbott Medical Optics Inc.
Priority to AU2017238487A priority Critical patent/AU2017238487B2/en
Priority to EP17715020.8A priority patent/EP3432768B1/fr
Priority to CA3018545A priority patent/CA3018545A1/fr
Publication of WO2017165623A1 publication Critical patent/WO2017165623A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • A61F2/1637—Correcting aberrations caused by inhomogeneities; correcting intrinsic aberrations, e.g. of the cornea, of the surface of the natural lens, aspheric, cylindrical, toric lenses
    • A61F2/1645—Toric lenses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/0016—Operational features thereof
    • A61B3/0025—Operational features thereof characterised by electronic signal processing, e.g. eye models
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • A61F2/1624—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • A61F2/1654—Diffractive lenses
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B27/00—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00
    • G02B27/0012—Optical design, e.g. procedures, algorithms, optimisation routines
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C7/00—Optical parts
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C7/00—Optical parts
    • G02C7/02—Lenses; Lens systems ; Methods of designing lenses
    • G02C7/04—Contact lenses for the eyes
    • G02C7/041—Contact lenses for the eyes bifocal; multifocal
    • G02C7/042—Simultaneous type
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C7/00—Optical parts
    • G02C7/02—Lenses; Lens systems ; Methods of designing lenses
    • G02C7/06—Lenses; Lens systems ; Methods of designing lenses bifocal; multifocal ; progressive
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F30/00—Computer-aided design [CAD]
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F30/00—Computer-aided design [CAD]
    • G06F30/20—Design optimisation, verification or simulation
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F7/00—Methods or arrangements for processing data by operating upon the order or content of the data handled
    • G06F7/38—Methods or arrangements for performing computations using exclusively denominational number representation, e.g. using binary, ternary, decimal representation
    • G06F7/48—Methods or arrangements for performing computations using exclusively denominational number representation, e.g. using binary, ternary, decimal representation using non-contact-making devices, e.g. tube, solid state device; using unspecified devices
    • G06F7/544—Methods or arrangements for performing computations using exclusively denominational number representation, e.g. using binary, ternary, decimal representation using non-contact-making devices, e.g. tube, solid state device; using unspecified devices for evaluating functions by calculation
    • G06F7/548—Trigonometric functions; Co-ordinate transformations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/02—Subjective types, i.e. testing apparatus requiring the active assistance of the patient
    • A61B3/028—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing visual acuity; for determination of refraction, e.g. phoropters
    • A61B3/036—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing visual acuity; for determination of refraction, e.g. phoropters for testing astigmatism
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B27/00—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00
    • G02B27/0075—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00 with means for altering, e.g. increasing, the depth of field or depth of focus
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C2202/00—Generic optical aspects applicable to one or more of the subgroups of G02C7/00
    • G02C2202/02—Mislocation tolerant lenses or lens systems
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C2202/00—Generic optical aspects applicable to one or more of the subgroups of G02C7/00
    • G02C2202/10—Optical elements and systems for visual disorders other than refractive errors, low vision
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C2202/00—Generic optical aspects applicable to one or more of the subgroups of G02C7/00
    • G02C2202/20—Diffractive and Fresnel lenses or lens portions
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C2202/00—Generic optical aspects applicable to one or more of the subgroups of G02C7/00
    • G02C2202/22—Correction of higher order and chromatic aberrations, wave front measurement and calculation

Definitions

  • This application is directed to providing correction for astigmatism, including provision to extend operable tolerance band of an ophthalmic apparatus to improve patient outcomes.
  • Existing toric lenses are designed to correct astigmatic effects caused by the corneal astigmatism by providing maximum cylindrical power that exactly matches the cylinder axis.
  • Anchors are used to maintain the toric lenses at a desired orientations once implanted in the eye.
  • existing toric lenses themselves are not designed to account for misalignments of the lens that may occur during the surgical implantation the lens in the eye or to account for unintended post-surgery movements of the lens in the eye.
  • the angularly-varying phase member includes a combination of angularly and zonally diffractive (or refractive) phase structure.
  • This structure in some embodiments, has a height profile (in relation to the face of the lens) that gradually varies along the angular position (i.e., at nearby meridian of the first meridian up) to provide off- axis operation up to a pre-defined angular position (e.g., about +5° or more from the first meridian).
  • OPD optical path difference
  • each step heights ti(r) and t 2 (r) corresponds to a respective maximum and a minimum height (i.e., the peak and trough) of the angularly-varying phase member.
  • the angularly and zonally diffractive phase structure varies along each meridian between the first meridian (which has the step height ti(r)) and meridian that are, in some embodiments, about 45 degrees and about -45 degrees to the first meridian.
  • the angularly-varying phase member establishes the band of operational meridian across a range selected from the group consisting of about +4 degrees, about +5 degrees, about +6 degrees, about +7 degrees, about +8 degrees, about +9 degrees, about +10 degrees, about +11 degrees, about +12 degrees, about +13, degrees, about +14 degrees, and about +15 degrees.
  • the multi-zonal lens body forms a second angularly- varying phase member at a second meridian that is orthogonal to the first meridian.
  • the second angularly- varying phase member in some embodiments, varies along each meridian nearby to the center of the second meridian i) between the second meridian and meridians that are, in some embodiments, about 45 degrees and about -45 degrees to the second meridian.
  • the first and second angularly-varying phase members form a butterfly pattern.
  • the first angularly-varying phase member and the second angularly-varying phase member form a double angularly varying efficiency bifocal optics.
  • the multi-zonal lens body includes at least three optical zones that forms an angularly varying efficiency trifocal optics. In some embodiments, the multi-zonal lens body includes at least four optical zones that forms an angularly varying efficiency quadric optics.
  • the angularly-varying phase member at the first meridian comprises a monofocal lens.
  • the second angularly-varying phase member at the second meridian comprises a second monofocal lens.
  • each of the meridians located at about 45 degrees and about -45 degrees to the first meridian comprises a bifocal lens.
  • each of the angularly-varying phase structure of the multi-zonal lens body at the meridians located at about 45 degrees and about -45 degrees comprises a first optical zone, a second optical zone, and a third optical zone, wherein the first optical zone has a first point of focus and each of the second optical zone and the third optical zone has a respective point of focus nearby to the first point of focus, and wherein the first optical zone has a first light transmission efficiency (e.g., about 50%) and each of the second optical zone and the third optical zone has a respective light transmission efficiency (e.g., about 25% each) that is less than the first light transmission efficiency.
  • first light transmission efficiency e.g. 50%
  • each of the second optical zone and the third optical zone has a respective light transmission efficiency (e.g., about 25% each) that is less than the first light transmission efficiency.
  • the ophthalmic apparatus includes a plurality of alignment markings, including a first set of alignment markings and a second set of alignment markings.
  • the first set of alignment markings corresponds to the center of the first meridian
  • the second set of alignment markings corresponds to the band of operational meridian.
  • a rotationally-tolerant ophthalmic apparatus e.g., toric interocular lens
  • the ophthalmic apparatus includes a multi-zonal lens body having a plurality of optical zones, where the multi-zonal lens body forms the angularly- varying phase member.
  • the angularly-varying phase member has a center at an astigmatism correction meridian that directs light to a first point of focus (e.g., on the retina).
  • a rotationally-tolerant ophthalmic apparatus for correcting astigmatism includes an astigmatism correcting meridian that corresponds to a peak cylinder power associated with a correction of an astigmatism.
  • the rotationally-tolerant ophthalmic apparatus includes a plurality of exterior alignment markings, including a first set of alignment markings and a second set of alignment markings.
  • the first set of alignment markings corresponds to the astigmatism correcting meridian
  • the second set of alignment markings corresponds to an operation band of the rotationally-tolerant ophthalmic apparatus.
  • the embodiment disclosed herein further includes a system that performs a power calculator to determine the spherical equivalent (SE) and cylinder power for an extended tolerant toric lens and ophthalmic apparatuses having the extended band of operational meridian.
  • this power calculator is selectable to account for the extended depth of focus, the extended depth of focus, the extended tolerance of astigmatism associated with the improved toric lens and ophthalmic apparatuses.
  • the power calculator is configured to predict the SE and IOL for the extended tolerant IOL, including an IOL configured to provide an extended range of vision or ERV IOL including ERV toric IOL, an IOL configured to provide an extended depth of focus or EDOF IOL including toric EDOF IOL, and an IOL configured to provide an extended tolerance of astigmatism (effect) or ETA IOL.
  • a method for determining optical configuration (e.g. IOL spherical equivalent and cylinder power) of a rotationally-extended tolerant ophthalmic apparatus for the selection thereof.
  • the method includes receiving, by a processor, measurement data associated with an eye of a patient; determining, by the processor, using a conventional power calculator, a spherical equivalent and cylinder power using the measurement data for an ophthalmic apparatus selected from the group consisting of an implantable rotationally-extended tolerant ophthalmic apparatus, an implantable extended range of vision (ERV) ophthalmic apparatus, and an implantable extended depth of focus (EDOF) ophthalmic apparatus;
  • ERP implantable extended range of vision
  • EEOF implantable extended depth of focus
  • MRSE manifest refraction spherical equivalent
  • the incremental RC is about 0.1 RC, about 0.2 RC, about 0.3 RC, about 0.4 RC, about 0.5 RC, about 0.6 RC, about 0.7 RC, about 0.8 RC, about 0.9 RC.
  • the implantable ophthalmic apparatus comprises the implantable rotationally-extended tolerant ophthalmic apparatus.
  • the implantable ophthalmic apparatus comprises the implantable extended range of vision (ERV) ophthalmic apparatus.
  • implantable ophthalmic apparatus comprises the implantable extended depth of focus (EDOF) ophthalmic apparatus.
  • the pre-determined rotational misalignment is a maximum expected rotational misalignment value determined for the given implantable ophthalmic apparatus.
  • the maximum expected rotational misalignment value is a maximum misaligned angle from an intended meridian, selected from the group consisting of +2°, +3°, +4°, +5°, +6°, +7°, +8°, +9°, and +10°.
  • the method further includes modifying the spherical equivalent by a value corresponding to the residual refractive error, wherein the residual refractive error is expressed in spherical equivalent.
  • the acceptable range of visual acuity comprises an uncorrected visual acuity (UCVA) state.
  • UCVA uncorrected visual acuity
  • the method further includes determining, by the processor, a potential manifest refraction spherical equivalent parameter and manifest residual cylinder tolerance level.
  • a non-transitory computer readable medium the computer readable medium having instructions stored thereon, wherein the instructions, when executed by a processor, cause the processor to: receive measurement data associated with an eye of a patient; determine using a conventional power calculator, a spherical equivalent and cylinder power using the measurement data for an ophthalmic apparatus selected from the group consisting of an implantable rotationally-extended tolerant ophthalmic apparatus, an implantable extended range of vision (ERV) ophthalmic apparatus, and an implantable extended depth of focus (EDOF) ophthalmic apparatus; determine a refractive or residual cylinder (RC) power associated with a random residual astigmatism power for the ophthalmic apparatus, wherein the random residual astigmatism power is associated with a pre-determined rotational misalignment for the apparatus once implante
  • RC refractive or residual cylinder
  • the implantable ophthalmic apparatus comprises the implantable rotationally-extended tolerant ophthalmic apparatus.
  • the implantable ophthalmic apparatus comprises the implantable extended range of vision (ERV) ophthalmic apparatus.
  • ERP implantable extended range of vision
  • the implantable ophthalmic apparatus comprises the implantable extended depth of focus (EDOF) ophthalmic apparatus.
  • the pre-determined rotational misalignment is a maximum expected rotational misalignment value determined for the given implantable ophthalmic apparatus.
  • the maximum expected rotational misalignment value is a maximum misaligned angle from an intended meridian, selected from the group consisting of +2°, +3°, +4°, +5°, +6°, +7°, +8°, +9°, and +10°.
  • the instructions when executed by the processor, cause the processor to: modify the spherical equivalent by a value corresponding to the residual refractive error, wherein the residual refractive error is expressed in spherical equivalent.
  • the acceptable range of visual acuity comprises an uncorrected visual acuity (UCVA) state.
  • UCVA uncorrected visual acuity
  • the instructions when executed by the processor, cause the processor to: determine a potential manifest refraction spherical equivalent parameter and manifest residual cylinder tolerance level.
  • the incremental RC is about 0.1 RC, about 0.2 RC, about 0.3 RC, about 0.4 RC, about 0.5 RC, about 0.6 RC, about 0.7 RC, about 0.8 RC, about 0.9 RC.
  • Figs. 1A and IB are diagrams of an exemplary ophthalmic apparatus (e.g., an interocular toric lens) that includes angularly-varying phase members (reflective, diffractive, or both) that provide an extended rotational tolerance of the apparatus in accordance with an illustrative embodiment.
  • exemplary ophthalmic apparatus e.g., an interocular toric lens
  • phase members reflective, diffractive, or both
  • FIGs. 2A, 2B, and 2C illustrate a plurality of exemplary height profiles of the anterior or posterior face of the ophthalmic apparatus of Figs. 1A and IB in accordance with an illustrative embodiment.
  • FIG. 3 is a schematic drawing of a top view of a human eye, in which the natural lens of the eye has been removed and replaced with an ophthalmic apparatus that includes angularly-varying phase members in accordance with an illustrative embodiment.
  • Figs. 4A and 4B are plots illustrating performance of a conventional toric lens designed to apply maximum cylinder power at a corrective meridian when subjected to rotational misalignment.
  • Figs. 5 and 6 show plots of off-axis performances of an exemplary ophthalmic apparatus (diffractive and refractive) that includes angularly-varying phase members in accordance with an illustrative embodiment.
  • Figs. 7A and 7B are diagrams of an exemplary ophthalmic apparatus that includes angularly-varying phase members in accordance with another illustrative embodiment.
  • Figs. 8 and 9 are diagrams illustrating height profiles of exemplary ophthalmic apparatuses of Figs. 1 and 7 in accordance with the illustrative embodiments.
  • Fig. 10 is a diagram of an exemplary multi-focal lens ophthalmic apparatus that includes angularly- varying phase members in accordance with an illustrative embodiment.
  • Fig. 11 is a diagram illustrating the multi-focal lens ophthalmic apparatus of Fig. 10 configured as a bifocal lens in accordance with an illustrative embodiment.
  • Fig. 12 is a diagram illustrating the multi-focal lens ophthalmic apparatus of Fig. 10 configured as a tri-focal lens in accordance with an illustrative embodiment.
  • Fig. 13 is a diagram of an exemplary ophthalmic apparatus that includes angularly-varying phase members in accordance with another illustrative embodiment.
  • Fig. 14 is a table of the ophthalmic apparatus of Fig. 13 configured as a trifocal lens in accordance with an illustrative embodiment.
  • FIGs. 15A and 15B are diagrams of an exemplary ophthalmic apparatus that includes angularly-varying phase members and an asymmetric height profile in accordance with an illustrative embodiment.
  • Figs. 16A, 16B and 16C illustrate a plurality of exemplary height profiles of the ophthalmic apparatus of Fig. 15 in accordance with an illustrative embodiment.
  • FIGs. 17A and 17B are diagrams of an exemplary ophthalmic apparatus that includes angularly-varying phase members and a symmetric height profile in accordance with another illustrative embodiment.
  • Figs. 18 A, 18B and 18C illustrate a plurality of exemplary height profiles of the anterior or posterior face of the ophthalmic apparatus of Fig. 17 in accordance with an illustrative embodiment.
  • Figs. 19A and 19B are diagrams illustrating a top and bottom view of an ophthalmic apparatus of Fig. 13 with extended tolerance band markers in accordance with an illustrative embodiment.
  • Fig. 20 is a flow chart of a method to determine the spherical equivalent (SE) and cylinder power for toric lenses and ophthalmic apparatuses having the extended band of operational meridian, an extended depth of focus, or extended range of vision, in accordance with an illustrative embodiment.
  • SE spherical equivalent
  • Fig. 21 illustrates an example toric calculator that can be configured to receive a selection of an IOL model in accordance with an illustrative embodiment.
  • Fig. 22 illustrates an exemplary computer that can be used determining optical configuration (e.g. IOL spherical equivalent and cylinder power) of a rotationally-extended tolerant ophthalmic apparatus for the selection thereof.
  • optical configuration e.g. IOL spherical equivalent and cylinder power
  • Embodiments of the present invention are generally directed to toric lenses or surface shapes, and/or related methods and systems for fabrication and use thereof.
  • Toric lenses according to embodiments of the present disclosure find particular use in or on the eyes of human or animal subjects.
  • Embodiments of the present disclosure are illustrated below with particular reference to intraocular lenses; however, other types of lenses fall within the scope of the present disclosure.
  • Embodiments of the present disclosure provide improved ophthalmic lens (including, for example, contact lenses, and interocular lenses, corneal lenses and the like) and include monofocal diffractive lenses, bifocal diffractive lenses, and multifocal diffractive lenses.
  • optical power means the ability of a lens or optics, or portion thereof, to converge or diverge light to provide a focus (real or virtual), and is commonly specified in units of reciprocal meters (m _1 ) or Diopters (D).
  • optical power means the optical power of the intraocular lens when disposed within a media having a refractive index of 1.336 (generally considered to be the refractive index of the aqueous and vitreous humors of the human eye), unless otherwise specified.
  • the optical power of a lens or optic is from a reference plane associated with the lens or optic (e.g., a principal plane of an optic).
  • a cylinder power refers to the power required to correct for astigmatism resulting from
  • the terms “about” or “approximately”, when used in reference to a linear dimension mean within plus or minus one percent (1%) of the value of the referenced linear dimension.
  • Figs. 1A and IB are diagrams of an exemplary ophthalmic apparatus 100 (e.g., an interocular toric lens) that includes angularly-varying phase members (reflective, diffractive, or both) configured to provided extended rotational tolerance in accordance with an illustrative embodiment.
  • the angularly-varying phase members has a center structure that applies cylinder power at a corrective meridian (e.g., the high power meridian).
  • Off-center structures of the angularly- varying phase members extends from the center structure in a gradually varying manner to apply cylinder power to a band of meridians surrounding the corrective meridian enabling the ophthalmic apparatus to operate off-axis (or off-meridian) to the corrective meridian (e.g., the astigmatism meridian).
  • These meridians may be referred to as a dynamic meridian.
  • the angularly- varying phase members includes an optimized combination of angularly and zonally diffractive (or refractive) phase structure located at each meridian to vary the extended depth of focus to a plurality of nearby focus points. Light directed to such nearby focus points are thus directed to the desired focus point when the ophthalmic apparatus is subjected to a rotational offset from a primary intended axis of alignment, thereby extending the rotational tolerance of the apparatus to an extended tolerance band.
  • this extended tolerance astigmatism band delivers cylinder power to correct for the astigmatism for a range of meridians (e.g., up to +5° or more), thereby eliminating any need for additional corrective measures (e.g., supplemental corrective devices or another surgical interference) when the implanted ophthalmic apparatus is not perfectly aligned to the desired astigmatism meridian in the eye.
  • additional corrective measures e.g., supplemental corrective devices or another surgical interference
  • an exemplified toric intraocular lens includes dynamic meridian or angularly varying efficiency quadric optics.
  • an exemplified toric IOL includes dynamic meridian or angularly varying efficiency trifocal optics.
  • an exemplified toric IOL includes double dynamic meridian or angularly varying efficiency bifocal optics.
  • the bifocal or trifocal feature may be disposed on one optical surface or on both optical surfaces of a single optical lens or on any surfaces of a multiple optical elements working together as a system.
  • the angularly-varying phase members is formed in a multiple-zone structure (shown as zones 120a, 120b, 120c), each having a spatially-varying "butterfly" shaped structure centered around the optical axis 106.
  • the first corrective meridian 110 focuses light that passes therethrough to a first foci (i.e., point of focus) and is intended to align with the astigmatic axis of the eye.
  • the angularly-varying phase members focus light that passes therethrough to a plurality of foci near the first foci.
  • both the heights of the lens and the spatial sizes, at each zone varies among the different axes to form the angularly-varying phase member.
  • the height profile of the lens varies at each axis as the first height profile gradually transitions (e.g., as shown by the curved profile 122) into the second height profile.
  • the first and second height profiles 116 and 118 are illustrated relative to one another in a simplified format. It should be appreciated that the height profiles are superimposed on a lens having a curvature, as for example, illustrated in Fig. 3.
  • height profiles herein are illustrated in a simplified form (e.g., as a straight line).
  • the height profiles for each zone may have other shapes - such as convex, concave, or combinations thereof.
  • the second corrective meridian 112 focuses light to a second set of foci.
  • the height profiles at axes nearby to the first high power meridian have a similar height profile, as the first high power meridian.
  • the height profile varies in a continuous gradual manner (e.g., having a sine and cosine relationship) along the radial direction. This can be observed in Figs. 2B and 2C.
  • This variation of the height profile along the radial axis provides a lens region that focuses light at the desired foci and other foci nearby.
  • radial offset i.e., misalignment
  • FIG. 3 is a schematic drawing of a top view of a human eye 302, in which the natural lens of the eye has been removed and replaced with an intraocular lens 100 (shown in simplified form in the upper portion of Fig. 3 and in greater detail in the lower portion of Fig. 3).
  • an intraocular lens 100 shown in simplified form in the upper portion of Fig. 3 and in greater detail in the lower portion of Fig. 3.
  • the natural lens occupies essentially the entire interior of the capsular bag 310.
  • the capsular bag 310 houses the intraocular lens 100, in addition to a fluid that occupies the remaining volume and equalizes the pressure in the eye.
  • the intraocular lens comprises an optic 101 and may include one or more haptics 326 that are attached to the optic 101 and may serve to center the optic 101 in the eye and/or couple the optic 101 to the capsular bag 310 and/or zonular fibers 320 of the eye.
  • the optic 101 has an anterior surface 334 and a posterior surface 336, each having a particular shape that contributes to the refractive properties of the lens. Either or both of these lens surfaces may optionally have an element made integral with or attached to the surfaces.
  • the refractive and/or diffractive elements on the anterior and/or posterior surfaces in some embodiments, have anamorphic or toric features that can generate astigmatism to offset the astigmatism from a particular cornea in an eye.
  • the optics 101 in some embodiments, comprises the interocular lens 100.
  • the interocular lens 101 includes angularly- varying phase members (reflective, diffractive, or both) that focus at a plurality of focus points that are offset radially to one another so as to provide an extended tolerance to misalignments of the lens 100 when implanted into the eye 302. That is, when the center axis of a corrective meridian is exactly matched to the desired astigmatic axis, only a first portion of the cylinder axis is focused at the desired point of focus (338) (e.g., at the retina) while second portions of the cylinder axis focuses at other points (340) nearby that are radially offset to the desired point of focus (338).
  • the desired point of focus 338
  • second portions of the cylinder axis focuses at other points (340) nearby that are radially offset to the desired point of focus (338).
  • the second portion of the cylinder axis focuses the light to the desired point of focus.
  • Artificial lenses e.g., contact lenses or artificial intraocular lenses
  • can correct for certain visual impairments such as an inability of the natural lens to focus at near
  • Fig. 4 includes plots that illustrated the above- discussed degraded performance of conventional toric lens when subjected to rotational misalignment.
  • This conventional toric lens is configured to provide 6.00 Diopters cylinder powers at the IOL plane, 4.11 Diopters cylinder power at the corneal plane, and a corneal astigmatism correction range (i.e., preoperative corneal astigmatism to predicted effects) between 4.00 and 4.75 Diopters.
  • the undesired added meridian power varies between a maximum of + 0.75 Diopters at around the 45-degree meridian angle (shown as 408) and at about the 135-degree meridian angle (shown as 410).
  • this undesired added meridian power is outside the tolerance of a healthy human eye, which can tolerant undesired effects up to about 0.4 Diopters (e.g., at the cornea plane) for normal visual acuity (i.e., "20/20 vision"). Because the undesired effects exceeds the
  • FIG. 5 shows plots illustrating modular transfer functions (MTFs) in white light for two toric IOLs (shown as 502a and 502b) each configured with angularly-varying phase members when subjected to off-axis rotations.
  • Fig. 5 illustrates the performance for a refractive toric IOL
  • Fig. 6 illustrates performance for a diffractive toric IOL.
  • an ophthalmic apparatus that includes angularly varying phase members has a lower maximum cylinder range (as compared to lens without such structure). Rather, the angularly varying phase members applies the cylinder power to a band surrounding the corrective meridian, thereby providing a continuous band that makes the lens may tolerant due to misalignment. As shown, in this embodiment, the sensitivity of the ophthalmic apparatus with the angularly varying phase member is less by 20% as compared to a lens without the angularly varying phase member.
  • the asymmetric height profile may be configured to direct light to a plurality foci.
  • the apparatus 100 with the asymmetric height profile 702 may be used for as a trifocal lens.
  • the apparatus with the asymmetric height profile 702 is used for a quad-focal lens.
  • the apparatus 100 with the asymmetric height profile 702 is used for a double bi-focal lens.
  • the apparatus 100 with the asymmetric height profile 702 is used for a mono-focal lens.
  • the apparatus 100 with the asymmetric height profile 702 is used for a combined bi-focal and tri-focal lens.
  • the lens is diffractive.
  • Figs. 11 and 12 are diagrams illustrating added cylindrical power, from the angularly varying phase members, in the radial and angular position in accordance with the illustrative embodiments.
  • Fig. 14 illustrates a table for a trifocal IOL configured with the angularly varying phase member.
  • the light transmission efficiency at a first corrective foci 1402 is about 100% while other foci along the same meridian is about 0%.
  • the ophthalmic apparatus includes a plurality of zones 1502 (shown as 1502a, 1504b, and 1504c).
  • Extended Depth of Focus Intraocular lenses
  • extended focus or extended depth of focus
  • the reference optic may have biconvex or biconcave surfaces, which may have equal radii of curvature, and an optical power or focal length that may be equal to an optical power or focal length of the test optic.
  • the depth of focus for the test optic and the reference optic are determined under the same aperture conditions and under equivalent illumination conditions. Examples of extended depth of focus lenses are described in U.S. Publication No.
  • the EDOF element may produce a depth of focus for each meridian.
  • the depth of focus may indicate a good focus for each meridian at a broader range of foci.
  • good focus may be a focus that proves useful for vision, and that may be measured using a point spread function, defocus curves, a modulation transfer function (MTF), or by analysis of the Zernike polynomial understood to those skilled in the pertinent arts.
  • MTF modulation transfer function
  • SE targeted is the planned post-operative refractive or residual sphere equivalent of, for example, a planned cataract surgery for an eye to receive an implant. It is typically determined by a doctor with tools like a toric calculator, personalized IOL power calculator, or pre- and/or in- surgery instrument.
  • White light a spectrum of light with different wavelengths commonly visible to the human eye such as the photopic or mesopic or even scotopic light.
  • the wavelength range typically ranges from 380nm to 750nm.
  • the range can be from 400nm to 700 nm.
  • the other filtered white light can be different.
  • the transmission of each wavelength can be different, from 0% to 100% if normalized.
  • an IOL calculator is disclosed to determine the spherical equivalent (SE) and cylinder power for toric lenses and ophthalmic apparatuses having the extended band of operational meridian, such as the rotational extended tolerant toric intraocular lens (hereinafter "ETA toric IOL”), described herein.
  • SE spherical equivalent
  • ETA toric IOL rotational extended tolerant toric intraocular lens
  • the IOL calculator may also be used for an extended rotational tolerant toric intraocular lens (hereinafter "ETA toric IOL”), an extended depth of field intraocular lens (hereinafter “EDOF IOL”), an extended depth of field toric intraocular lens (hereinafter “EDOF toric IOL”), an extended range of vision intraocular lens (hereinafter “ERV IOL”), and an extended range of vision toric intraocular lens (ERV toric IOL).
  • ETA toric IOL an extended rotational tolerant toric intraocular lens
  • EEOF IOL extended depth of field intraocular lens
  • EOV IOL extended depth of field toric intraocular lens
  • ERP IOL extended range of vision intraocular lens
  • ERP toric IOL extended range of vision toric intraocular lens
  • the exemplified IOL calculator determines a spherical equivalent and cylinder power to correctively apply to the toric lenses and ophthalmic apparatuses that beneficially minimize the residual refractive error associated therewith.
  • the error may be minimized for both the spherical equivalent and the cylinder power.
  • Fig. 20 is a flow chart of a method to determine the spherical equivalent (SE) and cylinder power for toric lenses and ophthalmic apparatuses having the extended band of operational meridian, an extended depth of focus, or extended range of vision.
  • SE spherical equivalent
  • cylinder power for toric lenses and ophthalmic apparatuses having the extended band of operational meridian, an extended depth of focus, or extended range of vision.
  • Step 1 In a workspace that presents visual representation of a calculator, the method, in some embodiments, includes presenting a list of IOL model (e.g., ETA IOL, ERV IOL, and EDOF IOL). As shown in Fig. 20, a selection of an IOL is received along with either measurements parameters collected at a keratometry measurement device or a graphical user interface configured to receive keratometry and/or biometry information (2002), for example, from a user such as a physician or clinician.
  • IOL model e.g., ETA IOL, ERV IOL, and EDOF IOL
  • Fig. 21 illustrates an example toric calculator that can be configured to receive a selection of an IOL model.
  • Table 1 illustrates a listing of example IOL models that may be displayed for selection in the IOL calculator.
  • Step 3 Predict random residual astigmatism power for the residual cylinder (2012).
  • the possible range of the refractive or residual cylinder (RC) can be calculated.
  • the residual meridian power can be calculated using an expected maximum value for . In the above example, if a given lens is designed to be tolerant up to 10 degrees of misalignment, can be specified as 10 degrees.
  • a 5-degree misalignment of the toric lens from the intended corrective meridian can cause a residual (refractive) of 0.75 Diopters RC and about 0.4 Diopters SE for distance vision.
  • the residual cylinder is outside the range of tolerance of a healthy human eye (e.g., the astigmatism tolerance of a typical human eye is about 0.4D at the cornea plane to produce a 20/20 vision)
  • a supplemental corrective lens such as a spectacle or contact lens
  • use of a supplemental corrective lens may still be needed to achieve normal visual acuity (i.e., 20/20 vision).
  • Step 5 Re-run the calculation and add the residual refraction through focus and meridian three-dimensional flow (e.g., 2014, 2004, and 2008). In some embodiments, this has the effect of providing an enhanced modulation transfer function through focus and additional through meridian at each focus plane. That is, after the update to the targeted SE, the corresponding other residuals (refractions) can be again simulated and calculated at each meridian at a position focused, at the positions in the front (myopia) of the focused position, which can be combined to generate the through focus and meridian refractions.
  • the corresponding MTFs are the through focus and meridian MTFs.
  • the through focus positions can be represented by the visual object in the interested distance, manifest refractions, or image focus positions relative to the retina.
  • the through focus performance can be represented by the MTF values at a given spatial frequency or a contrast or VA (simulated). This is the method of referred to as "3D flow.”
  • Step 6 Heighted the designed feature or benefit in the above range. That is, adjust the height profile of the lens (e.g., the lens height profile for a given angular phase member), for example, for a given zone.
  • Step 7 Output the spherical equivalent and power cylinder if all the powers at each meridians are in an acceptable ranges for the defined set of distance (2010).
  • the manifest refraction spherical equivalent (MRSE) parameter and/or manifest residual cylinder (MRC) are calculated by using, for example, a conventional clinic VA letter chart test with trial glasses.
  • Step 8 If all the powers at meridians are not in the desired range (e.g., as determined in Step 7) (2008), add residual cylinder power and repeat Steps 5-8.
  • the use of minimum added power allows the toric lenses and ophthalmic apparatuses to operate both in range of the IOL benefit - thereby potentially minimizing the residual refractive error, including SE and cylinder power - and maximizing the spectacle or contact lenses (CL) independence.
  • the benefits of the ETA IOL and ETA toric IOL as described in Figs. 5 and 6 can be maximally realized with intended post-operation vision achieving the uncorrected visual acuity of 20/20 vision.
  • the above disclosed new solutions can also be used for power calculations for multifocal toric, extended range toric, or other categorized IOLs for extended tolerance of astigmatism caused by factors including the cylindrical axis mi-alignment
  • the above mentioned solution can also be applied to power calculation for spectacle, contact lens, corneal inlay, anterior chamber IOL, or any other visual device or system.
  • Fig. 22 illustrates an exemplary computer that can be used for determining optical configuration (e.g. IOL spherical equivalent and cylinder power) of a rotationally- extended tolerant ophthalmic apparatus for the selection thereof.
  • the computer of Fig. 22 may comprise all or a portion of the IOL calculator, as described herein.
  • "computer” may include a plurality of computers.
  • the computers may include one or more hardware components such as, for example, a processor 2221, a random access memory (RAM) module 2222, a read-only memory (ROM) module 2223, a storage 2224, a database 2225, one or more input/output (I/O) devices 2226, and an interface 2227.
  • controller 2220 may include one or more software components such as, for example, a computer-readable medium including computer executable instructions for performing a method associated with the exemplary embodiments. It is contemplated that one or more of the hardware components listed above may be implemented using software.
  • storage 2224 may include a software partition associated with one or more other hardware components. It is understood that the components listed above are exemplary only and not intended to be limiting.
  • Processor 2221 may include one or more processors, each configured to execute instructions and process data to perform one or more functions associated with a computer for indexing images.
  • Processor 2221 may be communicatively coupled to RAM 2222, ROM 2223, storage 2224, database 2225, I/O devices 2226, and interface 2227.
  • Processor 2221 may be configured to execute sequences of computer program instructions to perform various processes.
  • the computer program instructions may be loaded into RAM 2222 for execution by processor 2221.
  • processor refers to a physical hardware device that executes encoded instructions for performing functions on inputs and creating outputs.
  • RAM 2222 and ROM 2223 may each include one or more devices for storing information associated with operation of processor 2221.
  • ROM 2223 may include a memory device configured to access and store information associated with controller 2220, including information associated with IOL lenses and their parameters.
  • RAM 2222 may include a memory device for storing data associated with one or more operations of processor 2221.
  • ROM 2223 may load instructions into RAM 2222 for execution by processor 2221.
  • Storage 2224 may include any type of mass storage device configured to store information that processor 2221 may need to perform processes consistent with the disclosed embodiments.
  • storage 2224 may include one or more magnetic and/or optical disk devices, such as hard drives, CD-ROMs, DVD-ROMs, or any other type of mass media device.
  • Database 2225 may include one or more software and/or hardware components that cooperate to store, organize, sort, filter, and/or arrange data used by controller 2220 and/or processor 2221.
  • database 2225 may store hardware and/or software configuration data associated with input-output hardware devices and controllers, as described herein. It is contemplated that database 2225 may store additional and/or different information than that listed above.
  • I/O devices 2226 may include one or more components configured to communicate information with a user associated with controller 2220.
  • I/O devices may include a console with an integrated keyboard and mouse to allow a user to maintain a database of images, update associations, and access digital content.
  • I/O devices 2226 may also include a display including a graphical user interface (GUI) for outputting information on a monitor.
  • GUI graphical user interface
  • I O devices 2226 may also include peripheral devices such as, for example, a printer for printing information associated with controller 2220, a user-accessible disk drive (e.g., a USB port, a floppy, CD-ROM, or DVD-ROM drive, etc.) to allow a user to input data stored on a portable media device, a microphone, a speaker system, or any other suitable type of interface device.
  • peripheral devices such as, for example, a printer for printing information associated with controller 2220, a user-accessible disk drive (e.g., a USB port, a floppy, CD-ROM, or DVD-ROM drive, etc.) to allow a user to input data stored on a portable media device, a microphone, a speaker system, or any other suitable type of interface device.
  • Interface 2227 may include one or more components configured to transmit and receive data via a communication network, such as the Internet, a local area network, a workstation peer-to-peer network, a direct link network, a wireless network, or any other suitable communication platform.
  • interface 2227 may include one or more modulators, demodulators, multiplexers, demultiplexers, network communication devices, wireless devices, antennas, modems, and any other type of device configured to enable data communication via a communication network.

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Abstract

La présente invention concerne un calculateur de LIO pour déterminer l'équivalent sphérique (ES) et la puissance du cylindre pour des lentilles toriques et des appareils ophtalmiques ayant la bande étendue de méridien opérationnel, tels que la lentille intraoculaire torique à tolérance rotative étendue. Le calculateur de LIO peut en outre être utilisé pour une lentille intraoculaire torique à tolérance rotative étendue, une lentille intraoculaire à profondeur de champ étendue, une lentille intraoculaire torique à plage de vision étendue, et une plage étendue de lentille intraoculaire à vision étendue.
PCT/US2017/023772 2016-03-23 2017-03-23 Calculateur de puissance pour un appareil ophtalmique avec méridiens correctifs ayant une tolérance ou bande opérationnelle étendue WO2017165623A1 (fr)

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AU2017238487A AU2017238487B2 (en) 2016-03-23 2017-03-23 Power calculator for an ophthalmic apparatus with corrective meridians having extended tolerance or operation band
EP17715020.8A EP3432768B1 (fr) 2016-03-23 2017-03-23 Calculateur de puissance pour un appareil ophtalmique avec méridiens correctifs ayant une tolérance ou bande opérationnelle étendue
CA3018545A CA3018545A1 (fr) 2016-03-23 2017-03-23 Calculateur de puissance pour un appareil ophtalmique avec meridiens correctifs ayant une tolerance ou bande operationnelle etendue

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US201662363428P 2016-07-18 2016-07-18
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